Depression and Anxiety As Predictors of Outcome After Myocardial Infarction
作者:
Richard,
Mayou David,
Gill David,
Thompson Ann,
Day Nicholas,
Hicks James,
Volmink Andrew,
期刊:
Psychosomatic Medicine
(OVID Available online 2000)
卷期:
Volume 62,
issue 2
页码: 212-219
ISSN:0033-3174
年代: 2000
出版商: OVID
关键词: myocardial infarction;outcome;depression;anxiety;predictors
数据来源: OVID
摘要:
Objective:The objective of this study was to investigate the significance of emotional distress immediately after a myocardial infarction as a predictor of physical, psychological, and social outcomes and resource use.Methods:In an epidemiological survey, demographic and cardiological data were obtained for all patients from a defined geographical area who had had a myocardial infarction (according to diagnostic criteria of the Monitoring Trends and Determinants in Cardiovascular Disease [MONICA] trial). Hospital survivors were interviewed and were asked to complete self-report assessments on mental state and quality of life. Full replies were available at baseline for 347 subjects. Self-report follow-up questionnaire information was collected 3 months and 1 year later.Results:Fifteen percent of patients scored as probable cases of anxiety or depression. They were more likely than noncases to report preinfarct distress and poor adjustment (as indicated on the 36-item Medical Outcome Study short form). There was an improvement at 3 months, but there was little overall or individual change after that time. Anxiety and depression did not predict subsequent mortality but did significantly predict poor outcome at 1 year on all dimensions of the 36-item short form quality-of-life measure and on specific measures of everyday activity and reports of chest pain, use of primary care resources, and secondary prevention lifestyle changes.Conclusions:Subjects who are distressed in the hospital are at high risk of adverse psychological and quality-of-life outcomes during the ensuing year. Our findings strengthen the argument for in-hospital identification and treatment of patients with depression and anxiety after myocardial infarction.
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